Hjalmarson, Jenny

KTH, School of Technology and Health (STH), Centres, Centre for Health and Building, CHB.

2014 (English)Doctoral thesis, comprehensive summary (Other academic)

Abstract [en]

The home should represent safety and security for the person who lives there, and this is an important factor for independence and autonomy in very old age. With aging populations, the needs for long-term care increase, care provided by spouses and/or from the growing home care sector. Injuries among these groups are common.

In this study, an ergonomics perspective was applied in the analysis of some basic daily activities performed by old persons and by home care workers, assisting.

The postures and movements of home care staff assisting at toilet visits, and transferring persons from wheelchair to toilet, were measured and analysed.

Some daily activities related to making food and washing clothes, performed by a group of persons between the age of 75 and 100, were measured and analysed.

The task of getting up from the floor – on your own and with the help of a walker equipped with a lifting device – was analysed with the help of older persons and nursing staff. The design was built on the knowledge gained from analysing how older people get up from floor.

Requirements for access with a four-wheeled walker in the local built environment were investigated.

Observations were made with the help of video recording. Postures were recorded with the CUELA measurement system. The VIDAR ergonomics evaluation instrument was used to register the participants’ experiences of discomfort and pain during getting up from the floor with or without the walker with a lifting device. Structured interviews were used to find out about older peoples’ experience of using the four-wheel walker.

It is concluded that ageing at home requires improved architectural and technical bathroom design and improved access in the local built environment.

Place, publisher, year, edition, pages

Stockholm: KTH Royal Institute of Technology, 2014. , 59 p.

Series

TRITA-STH : report, ISSN 1653-3836 ; 2014:1

Keyword [en]

Ergonomics, aging, work posture, four-wheeled walker, home care worker, living at home, accessibility

Abstract [en]

The aim was to analyze the home care workers’ movement patterns and postures of their backs, relating them to risks while helping an ambulatory care recipient to/from the toilet in a homelike environment. We found severe risks of unpredictable movements with exposed postures could explain many injuries. Because of high risk injuries, we suggest decreasing the time when the care recipient stands and the home care worker helps with clothing and personal hygiene. Another suggestion to decrease high risk is development of support in front of the recipient to prevent her/him falling forward.

Abstract [en]

BACKGROUND: Musculoskeletal disorders are common among home care workers, and the task of helping care recipients between wheelchair and toilet is described as particularly burdensome.

OBJECTIVES: This study’s objectives were to find out where exposure to risks is highest for overexertion injuries in the task of helping a care recipient move between wheelchair and toilet, and to suggest how the bathroom environment or assistive devices could be improved to decrease risk of injury.

METHODS: In a full-scale laboratory, home care workers helped persons move between wheelchair and toilet. The CUELA measurement system was used, combined with video observation, to record postures assumed during the task.

RESULTS: Maximum back inclination on average exceeded 40 degrees. This angle is, combined with rotation of the back and the weight of the care recipient, well over recommended limits for helping in the task. The knees were exposed to a particularly heavy load when the wheelchair was adjusted, taking off leg-rests.

CONCLUSIONS: Solutions should be developed which increase possibilities for the care recipient to participate and bear much of the load. Development of wheelchairs and other assistive devices should include usability aspects for the assisting care workers.

Clarkson, P.John

Abstract [en]

This study measured the postures of older people during cooking and laundry. A sample of men and women aged 75+ years (n=27) was recruited and observed in a home-like environment. Postures were recorded with a measurement system in an objective and detailed manner. The participants were videotaped to be able to see where 'critical' postures occurred, as defined by a trunk inclination of ≥60°. Analysis of data was facilitated by specially developed software. Critical postures accounted for 3% of cooking and 10% of laundry, occurring primarily during retrieving from and putting in lower cabinets, the refrigerator, laundry basket or washing machine as well as disposing into the waste bin. These tasks involve a great variation in postural changes and pose a particular risk to older people. The results suggest that the use of stressful postures may decrease efficiency and increase fatigue, eventually leading to difficulties with daily activities. The specific tasks identified during which critical postures occurred should be targeted by designers in order to improve the activities. A few examples are given of how better design can reduce or eliminate some of the postural constraints.

Abstract [en]

Objectives: To analyse the movement patterns of people over 75 years of age when getting up from the floor, and to find out what they describe as critical moments in getting up.

Design: Observation of old people performing get up from floor and evaluation of experiences in VIDAR evaluation program.

Setting: Tests were made in a laboratory environment

Participants: 20 participants, eleven women and nine men. The mean age was 79 years.

Result: Most elderly persons in this case did experience difficulties in getting up. The difficulties were mainly described in legs and were related to discomfort, weakness and balance issues. Most of the participants 18 of 20 made the getting up by themselves. The most of the participants 18 of 20 preferred a getting up including a position kneeling. The most critical part in getting were lifting one leg forward and then stretch the legs after kneeling, 17 of 18 described difficulties in this part.

Conclusions: When developing aids to help persons to get up the main goal should be to reduce load on legs and support balance for the user. Training should include balance and muscle exercise of the leg.

Keyword

Elderly, Getting up from floor, Falls, Mobilisation after fall, stand up, experience of getting up

Abstract [en]

Purpose: To develop assistive technology that would help an older person to arise from a kneeling position to a standing one. Methods: Developing a prototype, based on an inclusive design and then testing the prototype to verify the approach. The prototype was subsequently tested by a panel of 20 elderly users. These tests were observed and filmed. Participants' experiences of being lifted with the elevation seat were registered with the VIDAR ergonomic assessment system. Result: None of the 20 participants used a walker at that time. In response to a question of whether, assuming they might have to use a walker in the future, they thought that a walker with an elevating seat would be helpful, 18 said that it would. Two of the participants did not believe that they would ever have to use a walker. Conclusion: A simple assistive technology such as a walker equipped with an elevating seat would in many of these cases simplify matters and reduce the distress of people who fall often. In addition, such a device can allow people who fall often to live in their homes longer. For caregivers dealing frequently with people who fall, this assistive device can contribute to decreasing occupational injuries.

Hjalmarson, Jenny

Abstract [en]

Studies have shown that about a third of all persons over 65 years who live at home fall at least once a year. Development of a lifting device that can help people raise themselves up entirely on their own, or with minimal assistance, would be a revolutionary step for the individual as compared with the lifting devices in use today. A prototype has been developed and the prototype has been tested to verify the approach. Studies have been conducted with nursing staff in a nursing home to find out the conditions for how a walker equipped with a lifting beam could facilitate the work. For caregivers dealing frequently with people who fall, this assistive device can contribute to decreasing occupational injuries.

Glimskär, Bo

Abstract [en]

Accessibility for all is an overall goal in many communities around the world. The UN has the Convention on the Rights of Persons with Disabilities which Sweden along with many other countries has agreed to follow. The aim with this project was to analyse which environmental difficulties elderly people over 65 years of age experience in their daily life when walking with a four-wheeled walker. The focus area was the surroundings close to their home. It is necessary to learn more about the difficulties for people with disabilities as a base for future development of the built environment. The group of elderly is increasing daily. In Sweden the four-wheeled walker is a commonly used assistive device by the elderly when, for example, their balance decreases; this is why we chose to focus on this specific assistive device.